Sunday, December 25, 2011

Dismantling Labour’s disastrous £12 billion NHS IT programme may cost taxpayers more than keeping it going.Ministers announced on Thursday that they will speed up the scrapping of the National Programme for IT (NPfIT) after a review concluded “there can be no confidence that the programme has delivered or can be delivered as originally conceived”.It confirmed earlier reports that the central part of the scheme, allowing NHS staff across England to access any patient’s details, was unworkable while costs had increases and deadlines were missed.

The governance board of the programme will now be scrapped, and local trusts will be given the freedom to develop their own versions of the electronic care record rather than having the rules dictated by Whitehall. A new Cabinet Office oversight committee will monitor future IT investment to ensure money is not wasted.

But many trusts across England have large contracts with private suppliers to supply their care record systems, and their cancellation could leave taxpayers even more out of pocket.

The Department of Health’s own chief information officer, Christine Connelly, told MPs on the Public Accounts Committee in May that a £3bn deal with CSC to deliver systems in the north, midlands and east of England would cost more to get out of than to keep going.

She said: “Potentially, if you ask me about the absolute maximum, we could be exposed to a higher cost than the cost to complete the contract as it stands today.”

A decision will be made on the future of the contract later in the autumn.

However the Cabinet Office’s Major Projects Authority said that some parts of the £12.7bn programme had worked and would be retained, including the NHSmail email system and the Choose and Book process of arranging hospital referrals.

Andrew Lansley, the Health Secretary, said: “Labour’s NHS IT Programme let down the NHS and wasted taxpayers’ money by imposing a top-down IT system on the local NHS, which didn’t fit their needs.

“We will be moving to an innovative new system driven by local decision-making. This is the only way to make sure we get value for money from IT systems that better meet the needs of a modernised NHS.”

Roger Goss, co-director of the pressure group Patient Concern said: “Thank goodness politicians have decided to stop money being poured into a huge bottomless pit. Now we must pray that they don’t sanction pouring it into endless incompatible regional pits.”

About 2,500 doctors and dentists have been targeted by the tax authorities as probable tax dodgers.HM Revenue & Customs (HMRC) will send them warning letters in the next few days, telling them to pay within 21 days or face possible prosecution.

The threats are part of the Revenue’s efforts to recover unpaid tax owed by various professions and trades.

People selling on internet marketplaces, and electricians, will be targeted early next year.

As well as doctors and dentists, HMRC has already been paying special attention to the tax affairs of restaurant owners and their staff, plumbers, private tutors and scrap metal dealers, as well as people with money hidden in offshore bank accounts.

Last month, the Revenue added to its list of potential miscreants, announcing it would also be focusing on wealthy people who own homes abroad, as well as commodity traders.

Gary Ashford of the Chartered Institute of Taxation (CIOT) said doctors and dentists should not ignore the Revenue’s latest letters.

“HMRC will either ‘make a determination’, which would result in the taxpayer incurring significant additional charges, or refer the case to their criminal investigations department with a view to prosecution,” he said.

“They have offered the carrot of a relatively low penalty rate for doctors to get their affairs in order and 1,500 health professionals took it up, bringing in £10m for the Exchequer.

“Now they are wielding the stick at those who have not come forward,” he said.

Mr Ashford pointed out that the Revenue had been gleaning information from employers of doctors and dentists, such as locum agencies, drug companies and medical insurance firms.

“What we are now seeing is HMRC starting to use that information, to identify who has not notified HMRC of all their tax liabilities,” Mr Ashford pointed out.

Drinkers should be given separate daily and weekly alcohol limits to prevent them consuming their entire recommended allowance at the weekend, a leading doctor has said.Prof Nick Heather, of Alcohol Research UK, said current guidelines which stipulate people’s average drinking habits fail to tackle the problem of binge drinking.

He told MPs there should be two types of limit, one which dictates how much people can safely drink “on average” and one which should “stipulate an amount that should never be exceeded”.

The Department of Health previously stated that men and women should not exceed 21 and 18 units of alcohol per week respectively.

It now advises men should not “regularly” exceed three to four units of alcohol per day, with women not drinking on average more than two or three units, but people still mistakenly believe they can store up their alcohol allowance by abstaining during the week and consume excessive amounts on Friday and Saturday nights.

Prof Heather told MPs that there is a key distinction between chronic illness caused by regular heavy drinking and the injuries resulting from drunkenness after binge drinking.

As well as advising how much alcohol people can safely drink on a regular basis health authorities ought to specify that no more than eight units should be consumed in a single day, equivalent to about three 175ml glasses of wine or four pints of lager, he suggested.

He said: “The form that guidelines should take should be this, for example. Men should not drink more than X units per week, probably 21, and never more than Y units in a day, which might be eight, and as well there should be at least two days of abstinence.

“We should revert to the old weekly limits for the average guideline and have another daily limit which would never be exceeded on any day.”

Senior medical experts urged the Commons Science and Technology Select Committee, which is examining the evidence on alcohol guidelines, not to raise the current recommended drinking limits.

Prof Sir Ian Gilmore, Royal College of Physicians special adviser on alcohol and chairman of Alcohol Health Alliance UK, said the “tide of harm” in Britain’s hospitals made it imperitave alcohol levels do not rise.He said: “As someone who still looks after people with liver disease, and with hospital admissions rising, I think that any recommendation to increase limits would add to the tide of harm that we are seeing in our hospitals every day. Given the burden of harm that we’ve got, it’s vital that levels are not increased at this point.”

Foreign doctors who cannot speak English are to be banned from working in NHS hospitals and clinics, the Health Secretary will announce today.The NHS will introduce mandatory language tests for doctors moving to Britain after training elsewhere in the European Union.

The decision follows a series of cases in which patients have died or suffered poor care as a result of doctors speaking sub-standard English.

The issue was brought to national attention three years ago when Dr Daniel Ubani, a German-trained GP on his first out-of-hours shift in Britain, killed David Gray, 70, by giving him 10 times the normal dose of diamorphine.

In his speech to the Conservative Party conference today, Andrew Lansley will say that the Medical Act will be amended so that doctors must speak good English to practise in Britain.

“I am determined that doctors who come from overseas to work here in our NHS must not only have the right qualifications, but also the language skills to practise here,” the Health Secretary is expected to say. “We will amend the Medical Act to ensure that any doctor from overseas who can’t use a decent level of English is not able to treat NHS patients. This is not about discriminating; we’ve always appreciated how much overseas doctors and nurses give to our NHS. It is simply about our absolute commitment to put patients’ safety first.”

There are more than 88,000 foreign-trained doctors registered to work in Britain, including 22,758 from Europe. They account for almost a third of the total.

Under the proposals, local NHS trusts would have a duty to check the language skills of foreign-trained doctors before they can be employed. In addition, the General Medical Council would be given powers to take action against doctors when there were concerns about their ability to speak English. At present, only doctors from outside the European Economic Area are routinely scrutinised for their language skills before being registered by the GMC.

This means that doctors from Canada or Australia are routinely tested for their language skills while those from countries such as Poland and France are not.

It had previously been thought that European Union laws ensuring the freedom of movement of labour prevented language testing. However, the European Commission has recently stated that the language tests would be legal.

Dr Ubani, who admitted he had never heard of the drug he gave to Mr Gray, was struck off by the GMC in June last year but still practises in Germany. His poor English meant he was refused work by the NHS in West Yorkshire but was accepted in Cornwall and Camb-ridgeshire, where he saw Mr Gray.

Since the case, the GMC and other NHS leaders have repeatedly warned that some foreign doctors’ language skills are so poor that patients are being put at risk.

Compulsory language tests for foreign doctors will raise concerns that the NHS could be left short-staffed, such is its reliance on overseas medics. Ministers believe that the majority will reach the necessary standard of English.

Mr Lansley will today deliver a robust defence of the Government’s health policy, saying that money is being diverted from cutting bureaucracy to front-line services.

“Unlike Labour, we will make sure that every penny of our investment goes right to the patients who matter, not the huge Labour bureaucracy which we inherited,” he will say. “And all that is why, since the election, we now have 1,500 more doctors and 5,000 fewer managers in the NHS.”

He will also claim that hospital infection rates have fallen and the number of people being treated in mixed-sex wards has fallen by more than 90 per cent over the past eight months.

Drinking wine or eating grapes could protect you from sunburn, according to a new study that found a chemical in the fruit can limit cell damage.Ultraviolet (UV) rays emitted by the sun are the leading environmental cause of skin complaints, premature ageing, sun burn and even skin cancer.

But in another nod towards the healthy mediteranean diet, Spanish scientists found substances in the grapes protect cells from the damage.

Already cosmetic companies are registering interest in the hope of making sun creams or pills that copy the process.

The University of Barcelona and the Spanish National Research Council looked at the chemical reaction in the skin when hit by UV rays from the sun.

They found that flavonoids in the grapes can stop the chemical reaction that causes cells to die and therefore skin damage.

The study, carried out in vitro in the laboratory, has been published in the Journal of Agricultural and Food Chemistry.

Marta Cascante, a biochemist at the University of Barcelona and director of the research project, said it proves grapes could help protect the skin from sun burn and even skin cancer.

She said the research could help to develop skin creams and other products to protect skin from sun damage.

“This study supports the idea of using these products to protect the skin from cell damage and death caused by solar radiation, as well as increasing our understanding of the mechanism by which they act”, she said.

The study also adds to the popular image of the healthy and tanned population of the mediteranean.

Previous research has put the low cancer rates and good health down to tomatoes, olive oil and even red wine.

A London hospital’s trial of a prostate cancer drug has been stopped early because it was so successful doctors felt it would be “unethical” to deny the treatment to other patients.Medics halted tests of the life-extending drug because it would have been “unethical” not to offer the treatment to all 922 cancer sufferers taking part in the trial.

Patients who were given the drug found that it eased pain and caused only minor side effects.The new drug accurately targets tumours using alpha radiation, which doctors conducting the study said is the most effective form of radiation to eliminate cancer because it limits damage to surrounding tissue.

Dr Chris Parker, lead researcher on the project at the Royal Marsden Hospital, said: “It’s more damaging. It takes one, two, three hits to kill a cancer cell compared with thousands of hits for beta particles.”

The drug, Radium-223 Chloride – known as Alpharadin TM – will also do less damage to surrounding tissue because it accurately targets calls, the doctors said.

Speaking at an international gathering of cancer experts, Dr Parker, a consultant clinical oncologist, said: “They have such a tiny range, a few millionths of a metre. So we can be sure that the damage is being done where it should be.”

Patients taking the drug has a 30 per cent lower rate of death compared top patients taking a placebo pill.

“It would have been unethical not to offer the active treatment to those taking placebo,” Dr. Parker said.

Radium-223 has “a completely different safety profile” to chemotherapy, he added.

The trial’s results were presented this week at the 2011 European Multidisciplinary Cancer Congress in Stockholm.

The researchers, who have pointed out the urgent need for an effective treatment for prostate cancer, will now submit their findings for approval by regulators.

Prof Gillies McKenna, Cancer Research UK’s radiotherapy expert said: “This appears to be an important study using a highly targeted form of radiation to treat prostate cancer that has spread to the bones.”

“This research looks very promising and could be an important addition to approaches available to treat secondary tumours – and should be investigated further.”

Doing moderate exercise even for short amounts of time is still good for your heart- and your health according to new research.Academics estimate that just two and a half hours of cycling or brisk walking every week is enough to lower heart disease risk by 14 per cent.

However they add that people who do even more exercise will be healthier.

The Department of Health recommends that adults carry out at least 150 minutes of “moderate-intensity aerobic activity” each week as well as “muscle-strengthening activities” twice a week.

Jacob Sattelmair, of the Department of Epidemiology at the Harvard School of Public Health in America, said: “The overall findings of the study corroborate federal guidelines – even a little bit of exercise is good, but more is better – 150 minutes of exercise per week is beneficial, 300 minutes per week will give even more benefits.”

His paper, published in the journal Circulation, looked at 33 previous academic studies of physical activity and heart disease, nine of which measured leisure activity quantitatively.

Analysis suggested that those who engaged in 150 minutes of moderate-intensity exercise a week had a 14 per cent lower risk of coronary heart disease than those who reported taking part in no exercise.